SACRAMENTO, Calif — California's governor unveiled a plan Thursday to offer more services to homeless people with severe mental health and addiction disorders even if that means forcing some into care, a move that many advocates of the homeless oppose as a violation of civil rights.
The proposal by Gov. Gavin Newsom, a Democrat, would require all counties to set up a mental health branch in civil court and provide comprehensive and community-based treatment to those suffering from debilitating psychosis.
People would be obligated to accept the care or risk criminal charges, if those are pending, and if not, they would be subject to processes already in place, such as involuntary psychiatric holds or court conservatorships.
“One of the most heartbreaking, heart-wrenching and yet curable challenges that we face ... is how do we serve the needs of individuals who are the sickest of the sick?” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, at a news briefing in advance of a press conference by Newsom.
He said he expects the program called “Care Court” to apply to 7,000 to 12,000 people in California, although not all have to be homeless. Family members and outreach workers could recommend a person for a court-mandated program, which the governor's office plans to boost with more money for psychologists, treatment beds and services.
“The money is there. The investment is there. The beds are coming, the units are coming online,” said Jason Elliott, senior counselor to Newsom.
Currently, Laura’s Law in California allows for court-ordered outpatient treatment in certain conditions, but officials said it's only been used for about 200 people out of a state of nearly 40 million. Counties can opt in or out of the program.
Some advocates for the homeless have objected to forced care, but Newsom told the San Francisco Chronicle it is past time to talk about civil rights when people who are clearly in distress are ranting in streets and frightening or even attacking others.
"There’s no compassion with people with their clothes off defecating and urinating in the middle of the streets, screaming and talking to themselves,” said Newsom, a former mayor of San Francisco.
Ghaly said Thursday the plan is just the “beginning of a conversation" and that implementation would require legislative approval.
Newsom has made homelessness and housing a focus of his administration. Last year, he proposed and the Legislature approved $12 billion for new housing and treatment beds for the homeless and this year he has proposed an additional $2 billion, primarily to shelter people suffering from psychosis and behavioral health disorders.
Former Assembly Republican Leader Marie Waldron says she supports the initiative.
“If there's a way we can streamline care and actually provide, provide treatment to people who need it is absolutely critical and important," she said. "Mental health doesn't look at party lines,"
Although Republican Kevin Kiley said he’s not ready to take a stance. He fears it could be a get-out-of-jail-free card for some criminals.
“As a concept, it's perhaps something I could get behind," Kiley said, "but it really depends a lot on how that is set up. I mean, if you are having the ability for very serious offenders to commit very serious crimes, and avoid any real penalty for that, then that is a problem.”
What does Care Court provide?
Those going through outpatient treatment through the court-ordered program can expect short-term stabilization medications, wellness and recovery supports, as well as connection to social services and a housing plan.
Newsom stressed the care plans are culturally and linguistically competent county services. These include short-term stabilization medications, wellness and recovery supports, and connection to social services, including a housing plan. Services are provided to the individual through an outpatient model while they live in the community.
A public defender, and supporter to help make self-directed care decisions will also be assigned to a patient.
“Governor Newsom’s groundbreaking CARE Court proposal breaks through on a key missing piece of the homeless challenge,” said Sacramento Mayor Darrell Steinberg. “For people who are the sickest and most vulnerable on our streets, the governments responsible for helping them must be legally obligated to act.”
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